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Treatment centre staff check fear Treatment centre staff check fear
(41 minutes later)
By Matthew Hill BBC West Health Correspondent Joan Redfern's cancer was missedBy Matthew Hill BBC West Health Correspondent Joan Redfern's cancer was missed
Leading consultants are warning some NHS patients undergoing operations at Independent Sector Treatment Centres (ISTCs) are being put at unnecessary risk because their doctor has not been properly vetted by the Royal College of Surgeons.Leading consultants are warning some NHS patients undergoing operations at Independent Sector Treatment Centres (ISTCs) are being put at unnecessary risk because their doctor has not been properly vetted by the Royal College of Surgeons.
Angela Wood still finds talking about the last days of her mother very difficult.Angela Wood still finds talking about the last days of her mother very difficult.
Joan Redfern, 74, suffered an undignified death from cancer, the disease spread into her pelvis, causing secretions to seep out of her side.Joan Redfern, 74, suffered an undignified death from cancer, the disease spread into her pelvis, causing secretions to seep out of her side.
She was treated at Shepton Mallet Independent Sector Treatment Centre, a brand new hospital, where patients can enjoy fine views of the Mendip Hills.She was treated at Shepton Mallet Independent Sector Treatment Centre, a brand new hospital, where patients can enjoy fine views of the Mendip Hills.
For Joan it was less than a 20 minute drive from her home in Frome.For Joan it was less than a 20 minute drive from her home in Frome.
She was referred there by her GP for a bowel examination in 2007 after she developed digestive problems and anaemia.She was referred there by her GP for a bowel examination in 2007 after she developed digestive problems and anaemia.
Mrs Redfern's surgeon Mr Ben Mak had been appointed by UK Specialist Hospitals to work in Shepton.Mrs Redfern's surgeon Mr Ben Mak had been appointed by UK Specialist Hospitals to work in Shepton.
After carrying out a colonoscopy examination, he told Mrs Redfern she had an inflammation of the bowel.After carrying out a colonoscopy examination, he told Mrs Redfern she had an inflammation of the bowel.
However, six months later she was diagnosed with a 6cm cancer of the rectum at the Royal United Hospital in Bath.However, six months later she was diagnosed with a 6cm cancer of the rectum at the Royal United Hospital in Bath.
Her family were shocked that the large tumour had not been spotted at the earlier examination.Her family were shocked that the large tumour had not been spotted at the earlier examination.
Excruciating painExcruciating pain
Angela said the initial investigation had been excruciating for her mother, and thinks the surgeon should have looked more closely into the reason for the pain.Angela said the initial investigation had been excruciating for her mother, and thinks the surgeon should have looked more closely into the reason for the pain.
In hindsight I think Dr Mak should have questioned why he caused my mum so much pain and discomfort before any other procedure took place Angela Wood She said: "Mum has had quite a few rectal procedures. On this particular occasion he examined mum to the point that she yelled and she screamed out and she lifted her bottom from the table because she was in so much pain, this had never ever happened with any rectal examination to her before.In hindsight I think Dr Mak should have questioned why he caused my mum so much pain and discomfort before any other procedure took place Angela Wood She said: "Mum has had quite a few rectal procedures. On this particular occasion he examined mum to the point that she yelled and she screamed out and she lifted her bottom from the table because she was in so much pain, this had never ever happened with any rectal examination to her before.
"In hindsight I think Dr Mak should have questioned why he caused my mum so much pain and discomfort before any other procedure took place.""In hindsight I think Dr Mak should have questioned why he caused my mum so much pain and discomfort before any other procedure took place."
The Shepton ITSC wrote to Angela a month before her mother's death to say a DVD of the internal examination had been analysed as part of a review of colonoscopies carried out by Mr Mak between 2005 and 2008.The Shepton ITSC wrote to Angela a month before her mother's death to say a DVD of the internal examination had been analysed as part of a review of colonoscopies carried out by Mr Mak between 2005 and 2008.
The review has yet to be published, but the letter raised questions about the quality of the examination carried out on Mrs Redfern.The review has yet to be published, but the letter raised questions about the quality of the examination carried out on Mrs Redfern.
Mr Mak no longer works at the hospital. He was suspended, and his case has been referred to the General Medical Council by the UKSH, which refused to comment on a specific case.Mr Mak no longer works at the hospital. He was suspended, and his case has been referred to the General Medical Council by the UKSH, which refused to comment on a specific case.
Different proceduresDifferent procedures
In the NHS every surgeon has to be vetted by an expert in their field from the Royal College of Surgeons before they are appointed.In the NHS every surgeon has to be vetted by an expert in their field from the Royal College of Surgeons before they are appointed.
Joan was treated at Shepton Mallet Independent Sector Treatment CentreBut the same does not apply to ISTCs, despite a recommendation by a House of Commons Health Select Committee in 2005 for the same appointment procedure to be used. But the same does not apply to ISTCs, despite a recommendation by a House of Commons Health Select Committee in 2005 for the same appointment procedure to be used.
In a statement, Shepton ISTC defended its appointment procedure, dismissing the suggestion that it was not as robust as that used in the NHS.In a statement, Shepton ISTC defended its appointment procedure, dismissing the suggestion that it was not as robust as that used in the NHS.
It said a group of NHS doctors helped to vet candidates, and a second group of NHS experts assessed the skills and suitability of each doctor after they have been hired.It said a group of NHS doctors helped to vet candidates, and a second group of NHS experts assessed the skills and suitability of each doctor after they have been hired.
A Fellow of the royal College of Surgeons also helped assess potential surgeons prior to their appointment.A Fellow of the royal College of Surgeons also helped assess potential surgeons prior to their appointment.
The ISTC said Dr Mak had over 25 years experience as a surgeon before arriving at Shepton, and that he was qualified to perform colonoscopies.The ISTC said Dr Mak had over 25 years experience as a surgeon before arriving at Shepton, and that he was qualified to perform colonoscopies.
BBC surveyBBC survey
To investigate further current attitudes to ISTCs we surveyed trauma and orthopaedic surgeons about how happy they were with centres in their area.To investigate further current attitudes to ISTCs we surveyed trauma and orthopaedic surgeons about how happy they were with centres in their area.
Of the 41 clinical directors and lead clinicians who responded, 11 said their local ISTC did not use the Royal College of Surgeons when appointing staff.Of the 41 clinical directors and lead clinicians who responded, 11 said their local ISTC did not use the Royal College of Surgeons when appointing staff.
We are hearing there are definitely problems out there -they are many and varied. Dr Mike ParkerRoyal College of Surgeons One surgeon highlighted a case where a candidate was hired even after flunking very important questions at interview.We are hearing there are definitely problems out there -they are many and varied. Dr Mike ParkerRoyal College of Surgeons One surgeon highlighted a case where a candidate was hired even after flunking very important questions at interview.
Sixteen of the surgeons who responded reported cases where patient treatment had raised cause for concern, including cases in which surgeons said a death had potentially been avoidable.Sixteen of the surgeons who responded reported cases where patient treatment had raised cause for concern, including cases in which surgeons said a death had potentially been avoidable.
One surgeon highlighted a fatal pulmonary embolism which had been poorly treated by foreign night staff.One surgeon highlighted a fatal pulmonary embolism which had been poorly treated by foreign night staff.
Another highlighted a case in which a patient's radial artery was severed during an operation to remove a wrist ganglion.Another highlighted a case in which a patient's radial artery was severed during an operation to remove a wrist ganglion.
The Department of Health said it was confident ISTCs had rigorous recruitment procedures in place.The Department of Health said it was confident ISTCs had rigorous recruitment procedures in place.
Surgeons concernedSurgeons concerned
But Dr Mike Parker, from the Royal College of Surgeons, said action was needed.But Dr Mike Parker, from the Royal College of Surgeons, said action was needed.
He said: "We are hearing there are definitely problems out there. They are many and varied.He said: "We are hearing there are definitely problems out there. They are many and varied.
"What we are hearing is that there don't seem to be so many problems when the surgeons working in ISTCs are the same that work in the NHS in the area."What we are hearing is that there don't seem to be so many problems when the surgeons working in ISTCs are the same that work in the NHS in the area.
"But where they are not, then sometimes there have been problems."But where they are not, then sometimes there have been problems.
"We are concerned about the standards that are being kept.""We are concerned about the standards that are being kept."
• People living in the West of England can see an Inside Out West documentary on this survey this evening on BBC1 at 1930.• People living in the West of England can see an Inside Out West documentary on this survey this evening on BBC1 at 1930.